COVID-19 vaccination attitudes and intention among Quebecers during the first and second waves of the pandemic: findings from repeated cross-sectional surveys

Figures & data

Figure 1. COVID-19 vaccine intentions among the general public and among health care workers, data collected between April 23 to December 9, 2020.

Table 1. Vaccine intention and sociodemographic characteristics, data collected between November 27 and December 9, 2020

	N	Intend to be vaccinated	Do not intend to be vaccinated/ Do not know
Gender
Male	3236	74	26
Female	3405	68	32
Age
70 years and older	834	90	11
60–69 years old	1343	83	17
45–59 years old	1709	70	30
25–44 years old	2080	59	42
18–24 years old	675	65	34
Education
High school or less	2080	65	35
College	2849	72	29
University	1675	79	21
Material deprivation
Q1 (Less deprived)	1181	77	23
Q5 (most deprived)	965	66	34
Having CMCs or living with someone with CMCs
Yes	2107	79	21
No	4340	68	32
Areas of residence
Montreal Census Metropolitan Area	3017	74	26
Other Census Metropolitan Areas	1272	73	27
Cities with 10,000–100,000 inhabitants	751	70	30
Small cities (>10,000 inhabitants) and rural areas	558	71	29
Language
French	5651	71	29
English	980	73	27

Table 2. Vaccine intention and risk perceptions and adherence to conspiracy theories, data collected between November 27 and December 9, 2020

	N	Intend to be vaccinated	Do not intend to be vaccinated/Do not know
Perception of risks associated with COVID-19
Not afraid	2083	56	44
Moderately afraid	1521	74	26
Afraid	3034	81	19
Adherence to conspiracy theories
Yes	1374	50	50
No	5266	77	23

Figure 2. COVID-19 vaccine intentions among the general public and among health care workers, data collected between April 23 to December 9, 2020.

Table 3. Determinants of COVID-19 vaccine intention, data collected between November 27 and December 9 2020

Determinants^1	p-values (n)	Univariate Analysis (n = 6 037)		Multivariate analysis (n = 6 164)
		OR*	95% CI^†	OR*	95% CI^†
Gender (Women) Man	<0.001 (6,651)	1.33	1.20–1.48	1.80	1.56–2.06
Age (25–44 years)	<0.001 (6,651)
18–24 years		1.33	1.11–1.60	1.86	1.46–2.36
45–59 years		1.64	1.43–1.88	1.29	1.08–1.53
60–69 years		3.58	3.03–4.24	2.14	1.73–2.65
70 years +		6.33	4.97–8.08	3.44	2.57–4.58
Education (High school or less)	<0.006 (6,623)
College		1.36	1.21–1.54	1.37	1.17–1.60
University		2.08	1.80–2.42	2.01	1.66–2.43
Language (French) Other	<0.2884 (6,645)	0.92	0.79–1.07	-	-
Having CMCs or living with someone with CMCs (No) Yes	<0.001 (6,478)	1.86	1.64–2.11	1.39	1.18–1.63
Being a healthcare worker (No) Yes	<0.008 (6,651)	0.73	0.61–0.88	-	-
Areas of residence (Small cities and rural areas)	<0.001 (6,651)
Montreal Census Metropolitan Area (CMA)		1.16	0.10–1.36	-	-
Other CMAs		1.14	0.95–1.36	-	-
Other Cities > 10,000 inhabitants		0.97	0.79–1.19	-	-
Not known		0.55	0.44–0.68	-	-
Material deprivation (Most deprived Q5)	<0.001 (6,651)
Quintile 1		1.67	1.38–2.03	1.53	1.20–1.94
Quintile 2		1.41	1.17–1.70	1.34	1.06–1.68
Quintile 3		1.33	1.11–1.60	1.25	1.00–1.58
Quintile 4		1.17	0.97–1.41	1.14	0.90–1.44
Not known		0.82	0.68–1.00	1.10	0.85–1.42
Perception of risks associated with COVID-19 (Not afraid)	<0.001 (6,649)
Afraid		3.28	2.90–3.72	1.58	1.32–1.89
Moderately afraid		2.27	1.96–2.62	1.51	1.26–1.82
‘The measures taken by the Government of Quebec are adequate to ensure the safety of citizens with respect to the COVID-19 pandemic’ (Disagreement)^2 Agreement	<0.001 (6,618)	2.64	2.35–2.97	1.29	1.10–1.51
‘Contracting or living with someone having the COVID-19 would have significant consequences on my daily life’ (Disagreement)^2 Agreement	<0.001 (6,587)	1.61	1.42–1.81	-	-
‘My body could fight off the COVID-19 easily’ (Agreement) Disagreement	<0.001 (6,626)	2.64	2.32–3.01	1.28	1.07–1.52
‘There is little chance that I could get or spread COVID-19 from what I do in my everyday life’ (Disagreement)^2 Agreement	<0.001 (6,636)	1.30	1.16–1.46	-	-
‘Compliance with recommended measures’ (Not always)^2 Always	<0.001 (6.563)	1.89	1.69–2.11	-	-
Willingness to be tested if COVID symptoms (Unwilling or don’t know) Willing	<0.001 (6,634)	6.30	5.49–7.23	3.51	2.95–4.19
‘Most people I know follow recommended preventive measures’ (Disagreement)^2 Agreement	<0.001 (6,640)	2.43	2.02–2.92	1.39	1.09–1.79
‘I am complying with the recommended measures because I am forced to do so’ (Disagreement)^2 Agreement	<0.001 (6,640)	0.72	0.64–0.81	-	-
‘Young people do not comply with confinement rules and contribute to the spread of COVID-19ʹ (Disagreement)^2 Agreement	<0.001 (6,623)	2.20	1.95–2.50	-	-
‘It’s a good thing that police can easily give tickets to people who don’t comply with measures to prevent COVID-19ʹ (Disagreement)^2 Agreement	<0.001 (6,612)	5.12	4.52–5.81	1.76	1.48–2.10
‘It’s a good thing to stop group sports activities and to close fitness centers (gyms) in red zones’ (Disagreement)^2 Agreement	<0.001 (6,627)	3.43	3.06–3.85	1.47	1.25–1.72
‘The Canadian-United States border should remain closed at least until April 2021ʹ (Disagreement)^2 Agreement	<0.001 (6,632)	1.13	0.89–1.42	-	-
‘I’m afraid the health care system will be overwhelmed by COVID-19 cases following the holiday season’ (Disagreement)^2 Agreement	<0.001 (6,620)	5.12	4.39–5.98	1.44	1.15–1.79
Adherence to conspiracy theories (Adhering to conspiracy theories) Not adhering to conspiracy theories	<0.001 (6,651)	3.27	2.89–3.70	2.68	2.28–3.14
Emotional well-being (Positive emotional well- being) Negative emotional well-being	<0.001 (6,544)	2.00	1.76–2.28	1.49	1.25–1.79
Psychological distress (Low level of distress) High level of distress	<0.001 (6,507)	0.72	0.63–0.83	1.37	1.13–1.67

*Odds ratio

^†Confidence intervals

¹Reference category in parentheses ()

²Do not know category considered but not presented

Table

Concepts and items	Responses format	Analysis
Perceptions of risks associated with COVID-19
I consider myself to be at high risk of contracting COVID-19	‘Strongly Agree,’ ‘Somewhat Agree,’ ‘Somewhat Disagree,’ ‘Strongly Disagree,’ ‘I don’t know’	A risk perception score was created with all items (see Methods Section). The score into three clusters was tested in univariate and multivariate analysis
If I contract COVID-19, I will be placing my health at risk
I’m worried about the idea of contracting COVID-19
I’m worried about the idea of transmitting COVID-19 to people around me
I’m worried about the idea of losing someone I love due to COVID-19
Knowledge, beliefs and attitudes regarding preventive measures
Most of the people I know (family, friends) follow the recommended measures to prevent COVID-19. I am complying with the recommended measures because I am forced to do so. Young people do not comply with confinement rules and contribute to the spread of COVID-19. It’s a good thing that police can easily give tickets to people who don’t comply with measures to prevent COVID-19. The Canadian-United States border should remain closed at least until April 2021. I’m afraid the health care system will be overwhelmed by COVID-19 cases following the holiday season.	‘Strongly Agree,’ ‘Somewhat Agree,’ ‘Somewhat Disagree,’ ‘Strongly Disagree,’‘I don’t know’	Responses were dichotomized (Strongly Agree and Agree vs other responses formats). Individual items were tested in univariate and multivariate analysis.
Adherence to conspiracy theories
I think that many very important things happen in the world, which the public is never informed about. I think that politicians usually do not tell us the true motives for their decisions. I think that government agencies closely monitor all citizens. I think that events which superficially seem to lack a connection are often the result of secret activities. I think that there are secret organizations that greatly influence political decisions.	10-point scale ranging from ‘Totally false’ to ’Totally true’ with a do not know option	A conspiracy theory score was created by grouping all the items into one (cut off > 70%). The score was tested in univariate and multivariate analysis.
Psychological distress (K6)^Citation12
In the past 30 days, about how often did you feel … nervous? hopeless? restless or fidgety? [so depressed that nothing could cheer you up? that everything was an effort? worthless?	‘All the time’ ‘Most of the time’ ‘Sometimes’ ‘Rarely’ ‘Never’ ‘I don’t know’	A psychological distress score was created by grouping all the items into one (cutoff > 12). The score was tested in univariate and multivariate analysis.
Emotional well-being^Citation13
In the past 30 days, about how often did you feel … you were happy? you were interested in life? you were satisfied regarding your life?	‘All the time’‘Most of the time’ ‘Sometimes’ ‘Rarely’ ‘Never’ ‘I don’t know’	Dichotomized as follows: at least one item with ‘All the time’ or ‘Most of the time’ vs Other.
Attitudes and intention regarding COVID-19 vaccines
What is your level of agreement with the following statements? I intend to receive the vaccine against COVID-19 when it becomes available When the vaccine against COVID-19 becomes available, it should be mandatory for Quebecers to receive it	‘Strongly Agree,’ ‘Somewhat Agree,’ ‘Somewhat Disagree,’ ‘Strongly Disagree,’ ‘I don’t know’	Dependant variables Responses were dichotomized (Strongly Agree and Agree vs other responses formats).
What is the main reason you intend to receive the COVID-19 vaccine? To protect myself personally from COVID-19 To protect family members from COVID-19 To prevent the spread of COVID-19 in my community To put an end to the pandemic For other reasons I prefer not to answer		Descriptive statistics
In your opinion, what are the advantages of vaccination against COVID-19?	‘open-ended’	Qualitative content analysis
In your opinion, what are the disadvantages of vaccination against COVID-19?	‘open-ended’	Qualitative content analysis

Table

Determinants^1	p-values (n)	Univariate Analysis (n = 6 037)		Multivariate analysis (n = 6 164)
		OR*	95% CI^†	OR*	95% CI^†
Gender (Women)
Man	<0.001 (6,649)	1.15	1.05–1.27	1.36	1.21–1.53
Age (25–44 years)
18–24 years		3.99	3.32–4.81	1.98	1.59–2.46
45–59 years		1.16	0.98–1.39	1.37	1.11–1.70
60–69 years		1.59	1.40–1.81	1.14	0.98–1.33
70 years +		2.42	2.09–2.79	1.33	1.12–1.58
Education (High school or less)	<0.006 (6,623)
College		1.06	0.95–1.19	-	-
University		1.25	1.10–1.43	-	-
Language (French) Other	<0.2884 (6,645)	0.86	0.75–0.99	-	-
Having CMCs or living with someone with CMCs (No) Yes	<0.001 (6,476)	1.66	1.49–1.85	1.23	1.08–1.40
Being a healthcare worker (No) Yes	<0.0212 (6,649)	0.82	0.69–0.97	-	-
Areas of residence (Small cities and rural areas)	<0.001 (6,649)
Montreal Census Metropolitan Area (CMA)		1.12	0.97–1.30	0.84	0.68–1.02
Other CMAs		0.90	0.76–1.06	0.82	0.65–1.03
Other Cities > 10,000 inhabitants		0.92	0.76–1.12	0.64	0.44–0.95
Not known		0.55	0.45–0.68	1.36	1.10–1.68
Material deprivation (Most deprived Q5)	<0.001 (6,649)
Quintile 1		1.31	1.10–1.56	1.36	1.10–1.68
Quintile 2		1.24	1.04–1.47	1.34	1.09–1.65
Quintile 3		1.20	1.01–1.42	1.23	1.00–1.50
Quintile 4		1.07	0.90–1.28	1.10	0.90–1.35
Not known		0.85	0.70–1.02	1.64	1.18–2.27
Perception of risks associated with COVID-19 (Not afraid)	<0.001 (6,646)
Afraid		3.11	2.77–3.49	1.52	1.31–1.77
Moderately afraid		1.80	1.58–2.06	1.16	0.99–1.36
‘The measures taken by the Government of Quebec are adequate to ensure the safety of citizens with respect to the COVID-19 pandemic’ (Disagreement)^2 Agreement	<0.001 (6,616)	2.24	2.01–2.51	1.31	1.14–1.50
‘Contracting or living with someone having the COVID-19 would have significant consequences on my daily life’ (Disagreement)^2 Agreement	<0.001 (6,585)	1.70	1.51–1.90	-	-
‘My body could fight off the COVID-19 easily’ (Agreement) Disagreement	<0.001 (6,626)	1.97	1.75–2.21	-	-
‘There is little chance that I could get or spread COVID-19 from what I do in my everyday life’ (Disagreement)^2 Agreement	<0.001 (6,634)	1.16	1.04–1.29	-	-
‘Compliance with recommended measures’ (Not always)^2 Always	<0.001 (6,564)	1.86	1.68–2.06	1.20	1.06–1.69
Willingness to be tested if COVID symptoms (Unwilling or don’t know) Willing	<0.001 (6,632)	4.39	3.82–5.05	2.45	2.06–2.90
‘Most people I know follow recommended preventive measures’ (Disagreement)^2 Agreement	<0.001 (6,638)	2.01	1.67–2.42	-	-
‘I am complying with the recommended measures because I am forced to do so’ (Disagreement)^2 Agreement	<0.001 (6,611)	0.88	0.79–0.98	-	-
‘Young people do not comply with confinement rules and contribute to the spread of COVID-19ʹ (Disagreement)^2 Agreement	<0.001 (6,620)	2.43	2.16–2.74	1.34	1.15–1.55
‘It’s a good thing that police can easily give tickets to people who don’t comply with measures to prevent COVID-19ʹ (Disagreement)^2 Agreement	<0.001 (6,612)	4.72	4.16–5.35	1.83	1.55–2.15
‘It’s a good thing to stop group sports activities and to close fitness centers (gyms) in red zones’ (Disagreement)^2 Agreement	<0.001 (6,626)	3.23	2.90–3.61	1.40	1.22–1.62
‘The Canadian-United States border should remain closed at least until April 2021ʹ (Disagreement)^2 Agreement	<0.001 (6,630)	4.00	3.41–4.69	1.48	1.20–1.82
‘I’m afraid the health care system will be overwhelmed by COVID-19 cases following the holiday season’ (Disagreement)^2 Agreement	<0.001 (6,618)	4.76	4.04–5.60	1.37	1.10–1.70
Adherence to conspiracy theories (Adhering to conspiracy theories) Not adhering to conspiracy theories	<0.001 (6,649)	2.07	1.84–2.34	1.71	1.48–1.99
Emotional well-being (Positive emotional well-being) Negative emotional well-being	<0.001 (6,544)	1.66	1.47–1.88	1.30	1.10–1.53
Psychological distress (Low level of distress) High level of distress	<0.001 (6,504)	0.84	0.74–0.96	1.33	1.12–1.59

*Odds ratio

^†Confidence intervals

¹Reference category in parentheses ()

²Do not know category considered but not presented

Bruder M, Haffke P, Neave N, Nouripanah N, Imhoff R. Measuring individual differences in generic beliefs in conspiracy theories across cultures: conspiracy mentality questionnaire. Front Psychol. 2013;4:225. doi:10.3389/fpsyg.2013.00225.

 PubMed Web of Science ®Google Scholar

Pampalon R, Raymond G. A deprivation index for health and welfare planning in Quebec. Chronic Dis Can. 2000;21:104–13.

 PubMedGoogle Scholar